Supreme Court Reaffirms the Affordable Care Act

In a 6-3 decision today, the Supreme Court ruled that the Affordable Care Act allows the federal government to provide tax subsidies to help low-income and middle-class people purchase health insurance. The case was the latest challenge for President Obama’s signature domestic policy, and allows millions of Americans who have already purchased insurance through federal exchanges to keep their coverage.

Science Life recently spoke to Elbert Huang, MD, MPH, an associate professor of medicine at the University of Chicago, about the implications of the impending Supreme Court decision. Huang was a senior advisor in the office of the Assistant Secretary for Planning and Evaluation in the U.S. Department of Health and Human Services (HHS) when the ACA was in the early years of implementation, and understands the nuances of the legislation as much as anyone. After today’s decision, we asked him for a few more thoughts on the ACA’s future:

Elbert Huang, MD, MPH: Today the Supreme Court decided to uphold the constitutionality of subsidies for individuals buying health insurance through the federal exchanges. They interpreted the phrase “by the state” as ambiguous and looked at the broader intentions of the law which was to enhance access to health insurance for the whole nation.

This is a really important decision for the Affordable Care Act, President Obama, and the millions of people who have and will in the future enroll in health insurance through the exchanges. The law has now survived two Supreme Court cases, a presidential election, and numerous calls for repeal.

A lot of the discussion following the decision has focused on the politics of the decision but I am more relieved for individual patients. For individuals who purchased health insurance through the federal exchange, this provides stability in their health care and their personal finances. Now we have some sense of the rules of the road going forward.

There will be ongoing debate about the ACA but we are now entering a period of time where we will be able to move on to see if key elements of the law are working or not working. How were the individual penalties enforced by the IRS for the 2014 tax year? How will the small business exchanges be rolled out? What will happen to insurance premiums over time as the health system continues to evolve?